DESCRIPTION The Pathways Project is a comprehensive, school-based intervention designed to help reduce obesity in Native American children. Grades 3, 4, and 5 in forty schools from six American Indian nations are involved: Pima/Maricopa, Tohono O'odham, Navajo, White Mountain Apache, Oglala Lakota, and Sicangu Lakota. The intervention is implemented through representatives of the six nations and four cooperating universities: The Johns Hopkins University, the University of New Mexico, the University of Arizona, and the University of Minnesota with a fifth institution, the University of North Carolina, serving as the Coordinating Center. The design of Pathways is a randomized, controlled trial with the following components: physical activity, food service, classroom curriculum, and family involvement. The NHLBI funded a three-year feasibility study, whose results are summarized in the proposal, and now the PI's are requesting funding to begin the full-scale study, to be carried out over a five-year period.